Table C: TANF Medical Assistance Net Income Limits and Percentages of Poverty Level SR 02-10, 04/02 (FAM-A)

Assistance Group Size

PIL

QMB

< 100%

MCPW EMA Healthy Kids-Gold: age 0-19 < 185%

Healthy Kids-Gold: Infants age 0-1

> 185% < 300%

1

$ 559

$ 739

$1,366

$ 2,215

2

$ 675

$ 995

$1,841

$ 2,985

3

$ 683

$1,252

$2,316

$ 3,755

4

$ 691

$1,509

$2,791

$ 4,525

5

$ 698

$1,765

$3,266

$ 5,295

6

$ 779

$2,022

$3,741

$ 6,065

7

$ 842

$2,279

$4,215

$ 6,835

8

$ 935

$2,535

$4,690

$ 7,605

9

$ 987

$2,792

$5,165

$ 8,375

10

$1,064

$3,049

$5,640

$ 9,145

11

$1,151

$3,305

$6,115

$ 9,915

12

$1,223

$3,562

$6,590

$10,685

For each additional person add:

$ 257

$ 475

$ 770